Agreement offered linguistically of through conventional gestures. The basic paradigm of consent

Tacit consent

Agreement offered silently by not refusing.

Implied/implicit consent

Agreement that is inferred by others on the basis of actions

Presumed consent

Agreement that is inferred by others on the basis of what we know about the person's values and other actual choices.

Future/deferred consent

Agreement after the fact.

Elements of informed consent

1. Threshold
2. Informational
3. Consent

(3 answers)

Threshold elements

1. Competence to understand and decide
2. Voluntariness in deciding

(2 answers)

Informational elements

3. Disclosure of material information
4. Recommendation of a plan
5. Understanding of 3 and 4

(3 answers)

Consent Elements

6. Decision in favor of a plan
7. Authorization of the chosen plan

(2 answers)

Elements of Competence

1. To understand the material information
2. To make judgements about the information in light of their values
3. To intend a certain outcome
4. To communicate freely their wishes in light of their values.

(4 answers)

Kinds of influence

1. Coercion
2. Manipulation
3. Persuasion

(3 answers)

Coercion

Influence is coercion if and only if one person intentionally uses a credible and severe threat of harm or force to control another person

Manipulation

Influence in manipulation if and only if one person intentionally uses control over information or emotional appeals to control another person

Persuasion

Influence is persuasion if and only if one person intentionally uses reason to bring about a belief in the other

INFLUENCE BY PERSUASION DOES NOT COMPROMISE VOLUNTARINESS

Material information that mus be disclosed:

1. Those facts or descriptions that patients or subjects usually consider material in deciding whether to refuse or consent to the proposed intervention or research.
2. Information the profession believes to be material
3. The professional's recommendation
4. The purpose of seeking consent.
5. The nature and limits of consent as an act of authorization

(5 answers)

Understanding=

has acquired pertinent information about the diagnosis, prognosis, the nature and purpose of the intervention, alternatives, risks and benefits, and recommendations, and has JUSTIFIED, relevant beliefs about the nature and consequences of his or her action.

Kinds of surrogate decision making

1. Substituted judgement
2. Pure autonomy
3. Best interests

(3 answers)

Substituted Judgement

The surrogate should make the decision that the incompetent patient would have made if competent.

Pure Autonomy

The surrogate should make the decision that the incompetent patient expressed autonomously while still competent

Best Interest

The surrogate should make the decision that most benefits the patient, taking into consideration both the benefits and risks or costs